Journal ArticleDOI
Effect of Dialysis Dose and Membrane Flux in Maintenance Hemodialysis
Garabed Eknoyan,Gerald J. Beck,Alfred K. Cheung,John T. Daugirdas,Tom Greene,John W. Kusek,Michael Allon,James L. Bailey,James A. Delmez,Thomas A. Depner,Johanna T. Dwyer,Andrew S. Levey,Nathan W. Levin,Edgar L. Milford,Daniel B. Ornt,Michael V. Rocco,Gerald Schulman,Steve J. Schwab,Brendan P. Teehan,Robert D. Toto +19 more
TLDR
Patients undergoing hemodialysis thrice weekly appear to have no major benefit from a higher dialysis dose than that recommended by current U.S. guidelines or from the use of a high-flux membrane.Abstract:
Background The effects of the dose of dialysis and the level of flux of the dialyzer membrane on mortality and morbidity among patients undergoing maintenance hemodialysis are uncertain. Methods We undertook a randomized clinical trial in 1846 patients undergoing thrice-weekly dialysis, using a two-by-two factorial design to assign patients randomly to a standard or high dose of dialysis and to a low-flux or high-flux dialyzer. Results In the standard-dose group, the mean (±SD) urea-reduction ratio was 66.3±2.5 percent, the single-pool Kt/V was 1.32±0.09, and the equilibrated Kt/V was 1.16±0.08; in the high-dose group, the values were 75.2±2.5 percent, 1.71±0.11, and 1.53±0.09, respectively. Flux, estimated on the basis of beta2-microglobulin clearance, was 3±7 ml per minute in the low-flux group and 34±11 ml per minute in the high-flux group. The primary outcome, death from any cause, was not significantly influenced by the dose or flux assignment: the relative risk of death in the high-dose group as com...read more
Citations
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Journal ArticleDOI
The effects of frequent nocturnal home hemodialysis: the Frequent Hemodialysis Network Nocturnal Trial
Michael V. Rocco,Robert S. Lockridge,Gerald J. Beck,Paul W. Eggers,Jennifer J. Gassman,Tom Greene,Brett Larive,Christopher T. Chan,Glenn M. Chertow,Glenn M. Chertow,Michael Copland,Christopher D. Hoy,Robert M. Lindsay,Nathan W. Levin,Daniel B. Ornt,Andreas Pierratos,Mary Pipkin,Sanjay Rajagopalan,John B. Stokes,Mark Unruh,Robert A. Star,Alan S. Kliger +21 more
TL;DR: Patients in the nocturnal arm had improved control of hyperphosphatemia and hypertension, but no significant benefit among the other main secondary outcomes.
Journal Article
Effects of sevelamer and calcium-based phosphate binders on mortality in hemodialysis patients. Commentary
J. Silver,Wadi N. Suki,R. Zabaneh,J. L. Cangiano,Jon A. Reed,D. Fischer,L. Garrett,B. N. Ling,Scott Chasan-Taber,Maureen Dillon,Andrew T. Blair,Steven K. Burke +11 more
TL;DR: In this paper, the authors compared sevelamer and calcium-based binders on all-cause and cause-specific mortality (cardiovascular, infection, and other) in prevalent hemodialysis patients.
Journal ArticleDOI
End-Stage Renal Disease in the United States: An Update from the United States Renal Data System
Robert N. Foley,Allan J. Collins +1 more
TL;DR: Although first-year dialysis mortality rates have clearly improved since 1987, meaningful improvements do not seem to have accrued since 1993, in contrast to steady annual improvements in years 2 through 5, the same cannot be said for issues of cost; reflecting the growth in the size of the ESRD population, associated costs grew by 57% between 1999 and 2004 and now account for 6.7% of total Medicare expenditures.
Journal ArticleDOI
Mortality risk for patients receiving hemodiafiltration versus hemodialysis: European results from the DOPPS
Bernard Canaud,Jennifer L. Bragg-Gresham,Mark R. Marshall,S. Desmeules,Brenda W. Gillespie,Tom Depner,Preston S. Klassen,Friedrich K. Port +7 more
TL;DR: Observational results suggest that HDF may improve patient survival independently of its higher dialysis dose, and the potential benefits of HDF must be tested by controlled clinical trials before recommendations can be made for clinical practice.
Journal ArticleDOI
Effect of Online Hemodiafiltration on All-Cause Mortality and Cardiovascular Outcomes
Muriel P.C. Grooteman,Marinus A. van den Dorpel,Michiel L. Bots,E. Lars Penne,Neelke C. van der Weerd,Albert H.A. Mazairac,Claire H. den Hoedt,Ingeborg van der Tweel,Renée Lévesque,Menso J. Nubé,Piet M. ter Wee,Peter J. Blankestijn +11 more
TL;DR: This trial did not detect a beneficial effect of hemodiafiltration on all-cause mortality and cardiovascular events compared with low-flux hemodialysis, but on-treatment analysis suggests the possibility of a survival benefit among patients who receive high-volume hemodiiltration, although this subgroup finding requires confirmation.
References
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Nonparametric Estimation from Incomplete Observations
Edward L. Kaplan,Paul Meier +1 more
TL;DR: In this article, the product-limit (PL) estimator was proposed to estimate the proportion of items in the population whose lifetimes would exceed t (in the absence of such losses), without making any assumption about the form of the function P(t).
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Regression Models and Life-Tables
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Generalized Linear Models
Peter McCullagh,John A. Nelder +1 more
TL;DR: In this paper, a generalization of the analysis of variance is given for these models using log- likelihoods, illustrated by examples relating to four distributions; the Normal, Binomial (probit analysis, etc.), Poisson (contingency tables), and gamma (variance components).
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Generalized linear models. 2nd ed.
Peter McCullagh,John A. Nelder +1 more
TL;DR: A class of statistical models that generalizes classical linear models-extending them to include many other models useful in statistical analysis, of particular interest for statisticians in medicine, biology, agriculture, social science, and engineering.
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